Thanks for the support everyone. He's slowly coming to grips with this upcoming separation... I have talked with his parents, who plan to take him in an build a very structured atmosphere. But I have to get him out of here, if nothing else but it is an enabling place.
For now, separation and space. I will keep him on the insurance, try to find him some sort of program there, and probably send money to his parents to cover his medical bills. Still working out all the details.
Down the road, we'll have to get his vehicle back, but I can probably fly my brothers out to take it back there.
I have been thinking a lot, and part of the change has been that I have been far more a caregiver than anything else, and don't feel love in a romantic way anymore. I love him as a person, and hope he will accept that as enough.
I haven't seen much of him. He sleeps all day, every day (and nights, because "he's so exhausted." Aside from the fact that he has no clue what true exhaustion is (that would be 30 hours on your feet in the trauma bay on a Saturday night. Now THAT is exhaustion. I feel so insulted when he uses that word.)
He used to tell me that he slept so he wouldn't drink. He's just so dysfunctional. When I see glimmers of the man I used to know, I wonder if I'm doing the right thing, but I have had my heart broken so many times, and my dreams trampled that my head is overruling my heart. Which is a good thing.
Life goes on. And I'm guardedly optimistic about being single again. In fact, I'm rather looking forward to it. (I hired a cleaning servive. I'm outsourcing some of the yardwork.) I will be fine.